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NPI Code Detail

MEDICARE: KATHLEEN MARIE ROEDER M.S., A.R.N.P., B.C.

MEDICARE: KATHLEEN MARIE ROEDER M.S., A.R.N.P., B.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerARNP519902FL
2364SP0809XAdult Psychiatric/Mental Health Clinical Nurse SpecialistARNP519902FL

General Provider Information

NPI Number : 1447227996
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIE ROEDER M.S., A.R.N.P., B.C.
Provider Business Mailing Address
First Line : 10248 ARROW CREEK RD
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34655-4305
Country : US
Telephone Number : 727-375-9361
Fax Number :
Provider Business Practice Location Address
First Line : 9912 LITTLE RD
Second Line : VA OUTPATIENT CLINIC PASCO
City : NEW PORT RICHEY
State : FL
Zip : 34654-3419
Country : US
Telephone Number : 727-869-4153
Fax Number : 727-869-4193
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 09/11/2025

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